Cholecystitis

Etiology

  • Obstructing gall stone at cystic duct
  • Acalculous cholecystitis from stasis, often associated with severe illness in hospitalized patients
  • Organisms typically GNRs, enterococcus

Risk Factors

  • Cholesterol stones: Female, age > 40, obesity, Native American
  • Bilibubin stones (uncommon) from processes that cause hemolysis (e.g. sickle cell disease)

Symptoms

  • Fever
  • Constant right/upper abdominal pain
  • Can radiate to back, right shoulder
  • Nausea, vomiting

Physical Exam Findings

  • Pain in RUQ
  • Palpating hand positioned below liver→ patient inspires→ pain increases when inflamed gall bladder contacts hand (Murphy's Sign)

Tests